Patient Representative

Welcome to Zufall Health!

Position Summary

The Patient representative (PR) acts as a greeter to patients entering Zufall Health Center as well answer the telephone, complete registration, and conduct  intake as needed. The PR directs patients to the appropriate destination, answers questions, and explains processes, as well as reviews required documentation and checks eligibility. Most importantly, the PR supports the mission and vision of the Zufall Health Center.

Essential Functions, Duties and Responsibilities

• Consistently adheres to all departmental policies and procedures
• Conducts all aspects of job in a professional and ethical manner
• Works independently with little or no supervision but uses available resources for problem resolution as indicated by circumstances or need

• Completes assignments in a timely and efficient manner.
• Maintains high level of confidentially.
• Works collaboratively with team members to assure the optimal outcomes of care and service.

• Utilizes departmental resources prudently and appropriately.
• Uses communication methods which create and foster a positive image of the department, upholding the values of the Zufall Health Center.

• Communicates appropriately both verbally and in writing; uses appropriate mechanisms for identifying and resolving work related issues.
• Keeps manager or supervisor informed of work­ related issues at all times.
• Performs additional duties as determined by supervisor.

Specific Duties

Interaction with Patients

• Greets all visitors to the facility and directs them to their appropriate destination.
• Greets patients and visitors in a prompt, pleasant, and helpful manner in person and on the telephone.
• Answers the telephone and makes appointments or responds to inquiries.
• Ensures that the patient brings all supporting documentation to visit.
• Reminds patient of appointment time, documentation needed, immunization records for new patient pediatric appointments, and schedules and re-schedules appointments. 
• Explains processes and forms to patients as needed.
• Conducts eligibility checks on insurances.
• Collects payments from patients, enters the payment in eCW and prints receipts for patient.  PR’s are responsible for the money they collect and ensuring that it is locked in the safe or locked drawer at their desk or in supervisor’s office at all times.  Keys to drawers are never to be left in the open. 
• Communicates with the medical staff regarding patient’s visits. 
• Assists with printing out requisitions or other forms as needed.
• As PR’s are in the public areas, they should present themselves always as professional and friendly, and act as a team player in all situations.  They are responsible for keeping their personal areas and their surrounding public areas neat and clean and should routinely “straighten up” during the day.  
• Appearance of attire and possessions: PR’s should keep their “scrubs” that they wear in good condition, clean and neat.  Only Zufall jackets are to be worn over scrubs.  Wearing of personal sweaters or sweatshirts are not allowed.  Only white T shirts are allowed under scrubs and clean sneakers are to be worn.  No personal clothing or possessions are to be visible at their desk or on the back of the chair.  This includes cell phones which should never be taken out, for any reason in an area where patients are allowed, regardless of whether or patients or visitors are present.  
• PR’s are hired as a PR I.  They remain at this level during their initial training and after three months of employment are required to take an exam which covers all of the material that is required to perform their duties.  It includes but is not limited to customer satisfaction, telephone encounters, refill processes, insurances, registration of patients, special population definitions, HIPAA, compliance and Zufall policies and procedures. Staff will have three opportunities to pass the exam.  If they do not pass at their first or second try they will be given additional training.  If however, they fail three times, they will be terminated.

Additional duties for a Senior Patient Representative

• Senior Patient Representative(s) (SPR) are staff member(s) who have achieved the level of PR II, and have been employed approximately one year. They perform additional duties on a regular basis in addition to the duties of the PR I or PR II which requires specific training or knowledge.  These duties may include but are not limited to:

1. The processing of medical referrals
2. Managing the influx of patient inquiries through the patient portal and assigning as needed.
3. Participating in projects as team members, offering advice related to their job function, or acting as tour guides or organizers for various functions.
4. Overseeing the flow of patients with appointments and walk-ins.
5. Acting as supervisor when the regular supervisor or manager is away, handling all patient and facility issues. It does not include acting as an evaluator of the other staff members’ performance.

The PR II(s) who qualify to apply for the SPR position will be assigned additional duties and will receive a promotion in title to “Senior Patient Representative” along with a salary increase.  The Supervisor of the site’s patient representatives will submit a position request for a SPR to the Director of Operations who will determine if it is justified, and will then forward the request to the CEO and COO.  SPR’s should be seasoned employees with complete knowledge of their general duties and be in good standing in their position in regards to attendance and knowledge of policies and procedures.   They are expected to be leaders and act as a role model at all times.  They will undergo an interview process and a review of their previous evaluations.  A re-assessment of their job knowledge may be done, as well as taking into consideration their management skill set including organizational abilities, interpersonal skills, and demonstrated initiative. 

Communication

• Maintains patients’ confidentiality in compliance with HIPAA and other federal, state and local regulations as stated in the ZHC policies and procedures manual.
• Answers inquiries of patients and public in person or via telephone regarding regulations and services; when necessary, refers inquiries to appropriate person or department.
• Reads, writes, speaks, understands, and communicates in English and Spanish sufficiently to perform the duties of this position.

Knowledge, Skills and Abilities

Has knowledge of computer software programs such as Microsoft Word, and electronic medical records.

Have excellent customer service skills.

Be able to work with very little supervision.

Be able to adapt quickly to unanticipated changes in work flow or work process, or frequent changes in insurances rules and coverage changes.

Be able to understand, carry out, and remember verbal and written instructions.

Bilingual English and Spanish required.

Education, Training and Experience

High School diploma required; college credit or additional education in medical field or insurance and billing courses preferred

Possess a current, unrestricted New Jersey operator license issued by the New Jersey Division of Motor Vehicles, or be able to efficiently and effectively use public transportation in order to be able to travel to other sites as needed.

Have minimum of 1 year experience in customer service field, and 1 year of experience in collecting money or billing and insurances.

Experience in a clinical/ambulatory care setting preferred